End of life care

This is a discussion on End of life care within the Off Topic & Humor Discussion forums, part of the The Back Porch category; Great thread topic. Even if you have made plans, filled out papers, talked to your doc, do what I myself have been putting off. You ...

Great thread topic. Even if you have made plans, filled out papers, talked to your doc, do what I myself have been putting off. You need to go through the stuff periodically and make sure they still are current with your state's present law; that your doc still has the stuff on file and you haven't switched docs, hospitals etc., that your spouse or designated decision maker really is on the same page with you and actually is the person named in the documents you filled out 10 years ago.

And assume nothing. My mother had papers which she gave her doc and asked to be inserted into her medical records. When I later asked about these the doc, the records dept., and everyone at the large multi-doc clinic went "duh," we can't find them.
Fortunately, they were not needed.

We all hope we will go the way my grand dad did. He sat down on the bed, told my grandmother he never felt better in his life, and when she turned to answer him he was dead. But, most of us won't go that peacefully. And some will want to hang on beyond all reason for every second. So, make sure your family and care givers know your wishes.

Before coming over I had a living will and advance directive drawn up, signed and notarized and a copy is in my file at the doctors office and I have discussed it with my physician and my wife is fully aware of my wishes. One thing I have had to make explicit to all involved is "If I suffer any kind of brain injury with a likelihood of 50% or less recovery of mental/physical ability there is to be NO attempt to save my life". If my wishes are not followed and if I recover use of my right index finger someone is in deep doo doo

I have also stipulated that when I die my body is to be striped of all usable parts; organs, bones & skin and what is left to be cremated and scattered in a state or national forest.

I recently found myself thrust into a similar situation. My brother who was only 18 mos. older than me had an onset of several health problems in a short period of time. A small stroke, a slight heart attack, mild diabetes which all apparently contributed to early onset Alzheimer's related dimentia. He was judged incompetent and with no other relatives I was court appointed as his legal guardian. This past November, at the assisted living facility at which he resided, he had a massive stroke. The doctors wanted to insert a feeding tube and breathing tube to keep him alive while they assessed the damage. They said it would take from several days to several weeks to determine how much brain damage he had and what their plan for his care would be. I contacted his primary care physician who concurred with the hospital staff. Let me just say that I never want to be in a position where I had to make a life and death decision for anyone, especially a close relative. Before his stroke, my brother was incontinent, he didn't recognize anyone except my wife and myself and he never left his room and rarely got out of his bed. His TV was left on 24/7 and he had no idea what was playing at any given time. In short, he had no quality of life. And that was what he would have had to look forward to if the doctor's could manage to save his life. I contacted the local Hospice and reviewed his case with one of their councilors. They agreed with me whole-heartedly that my brother was a perfect candidate for the Hospice program and we had him transported to their facility that same day. The Hospice facility seemed more like a fancy motel room than a medical facility. I swear that unhooked from all but the necessary vital sign devices, my brother, though in a coma, was relaxed and calm. His face had a sereneness about it that I hadn't seen for years. He passed away the next day. His primary care physician called me a few days later and thanked me for doing the right thing.

When my Father was dying from extreme dementia, my Mom deferred decisions to me. She could not make any decisions regarding feeding tubes, hospice care, etc. I did what was needed based on an old conversation with Dad regarding no extreme measures to preserve life. Three years later, Mom paralleled Dad and I had to make decisions for her end of life due to her dementia. My older sister was incapable of emotionally helping me, so I twice had to say no to gaining a few hours or days to prolong their life. Guess what my burden in life is. Guess why I no longer smile very much. Dad, 9/9/2006... Mom 4/13/2010.

I know the situation; my mother had Parkinson's, had deteriorated to the point she was bed ridden and often slept 2 and 3 days at a time. My sister called one day (she was primary care giver) to say mom had developed a urinary tract infection and hospice recommended no treatment, allowing the infection to go septic and take her. It is not an easy decision, even though she had made her wishes unmistakably clear while she still had full faculties.

Also have an "Enduring Power of Attorney", "Power of Attorney with Durable Provisions". "Health Care Power of Attorney", "Advance Directive with specific empowerment of an Attorney-in-Fact to make health-care decisions for the grantor, up to and including terminating care and ending life supports that are keeping a critically and terminally ill patient alive" or what ever it is called in your jurisdiction.

IMHO, the best person to see to get all this nailed all this down is an Attorney-at-Law who specializes in estate work in your jurisdiction.

I've seen some real donny-brooks when all the "t"s weren't crossed and "i"s weren't dotted exactly right. I am just finishing up as the administrator of one estate that took me eight years to reslove all the legal and tax issues and there was under $100K involved.

If you have money to manage be sure that is covered, also -- in some form of "Enduring Power of Attorney", etc.

Under the common law, other types power of attorney becomes ineffective, if its grantor becomes "incapacitated," meaning unable to grant such a power, because of physical injury or mental illness (even if it was done before such "incapacitation").

BTW -- having been caught up in making funeral arrangements (a number of times) and having been the administrator of one estate (when the will & executor was not accepted by the Court), having been appointed administrator of an "Intestate Estate", and having been the executor of other estates -- my wife and I even prepaid and made all the arrangements for our funerals (because at the time all out kids were living in other States or were out of the country).

Put the smile back. You did what you were obligated to do to your best ability and you did it believing that you were fulfilling your parent's wishes. You did right. Don't aggravate yourself second guessing. Be kind to yourself.

Put the smile back. You did what you were obligated to do to your best ability and you did it believing that you were fulfilling your parent's wishes. You did right. Don't aggravate yourself second guessing. Be kind to yourself.

+ 1

BTDT -- both parents.

You need to take strength in your having had the strength to do what they wanted, under very difficulty conditions -- a strength that many cannot muster.